1. Field of the Invention
In general, the invention relates to surgical implants, and in particular to a malar implant with dual-plane adhesion.
2. Description of Related Art
The malar fat pads lie just under the skin of the cheeks, over the zygomatic bones and maxilla, and give definition to the cheeks. In a young face, the prominence, position, and volume of the malar fat pads provide much of the classic “youthful” facial appearance. As the face ages, the malar fat pads lose both elasticity and tissue, and the effects of gravity cause them to descend. Aging also causes changes in the underlying bone, and ultimately, a significant difference in the appearance of the mid-face.
Mid-face lifts are surgical procedures used to restore the youthful appearance of the face by, among other things, re-setting the position of the malar fat pads. Traditionally, this has been done endoscopically, by making a number of small incisions in the face, dissecting the facial tissue subperiosteally, and placing sutures strategically to tighten and lift the face. The malar fat pad is generally fastened to the temporalis fascia.
A newer method, called a ribbon lift, is also used. In a ribbon lift, the face may be dissected endoscopically, as described above, or an incision may be made less invasively behind the lower eyelid. A device that has a spiked or tined portion and a connected ribbon portion is inserted into the incision and moved under the malar fat pad. The spiked or tined portion adheres to the tissue of the malar fat pad, and the elongated ribbon connected to it allows the surgeon to pull the malar fat pad into a more desirable position. The surgeon then secures the ribbon in place. The ENDOTINE® MID-FACE ST (MicroAire, Inc., Charlottesville, Va., United States) is one of the better-known mid-face ribbon-type implants. The principles of implants with spikes for soft tissue are described in U.S. Pat. Nos. 6,645,226 and 6,485,503, both of which are incorporated by reference in their entireties. While the ENDOTINE® MID-FACE ST does reposition the soft tissue, it does not add any additional volume to the underlying structures of the mid-face—any appearance of additional volume is created by repositioning the soft tissue.
There are also implants that are intended to add volume to the cheeks. U.S. Pat. No. 4,790,849, which is incorporated by reference, is one early example of this. The MEDPOR® cheek implant (Stryker Corporation, Kalamazoo, Mich., United States) is currently one of the more popular devices. These kinds of implants are not typically secured to the bones, but may adhere to the soft tissue, and do not reposition or suspend the soft tissue of the mid-face.